RECURRENCE-FREE SURVIVAL AFTER PARTIAL NEPHRECTOMY FOR RENAL TUMORS IN SOLITARY KIDNEYS
Ключевые слова: рак единственной почки, местный рецидив, отдаленные метастазы, безрецидивная выживаемость, факторы прогноза.
Objective. Analysis of recurrence-free survival of patients with the solitary kidney malignancies exposed to a surgical interference. Development of a prognostic classification determining the risk of the tumorous process recurrence by the preoperative data.
Materials and methods. 108 patients with tumor in a solitary kidney who underwent open surgical partial nephrectomy performed at the Oncourology Department of the N. N. Alexandrov National Cancer Centre of Belarus with a primary focus on recurrence-free survival were enrolled in the study. Oncological outcomes were evaluated at a mean follow up of 66.2 months. Local recurrence and distant metastases developed in 32 (29.6%) patients.
Results. According to the performed multifactor analysis the strongest predictors of tumor recurrence were found to be the following: ESR³26 mm/h, hemoglobin <114 g/l and multifocality presence. According to the prognostic classification designed, the probability (HR) of tumor progression in the maximum risk group was 3.1 times higher (95% CI HR 1.3—7.5; р=0.014) than in the group of a high risk and 11 times higher (95% CI HR 4.3—27.7; р<0.001) than in the group of a low risk progression.
Conclusion. The classification designed allows single out patients at the maximum, a high or a low risk for the tumor recurrence after nephron sparing surgery for tumors in a solitary kidney the prediction being accurate (C-index 74%).